Community Engagement Survey

Your Hospital. Your Voice. Our Future.

Your feedback is important to us! We are looking to our community, patients and partners to help imagine the future of Headwaters. Please complete this short survey to give us feedback on the strengths and opportunities to improve our hospital, and to share what’s most important to you and your family, in your community hospital.

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1.When is the last time you or a family member visited Headwaters hospital?

In the last year

In the past 1 - 2 years

Over 2 years ago

Never

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2.During or after your last visit to Headwaters, how did you feel? (Please check all that apply)

Supported

Safe

Comfortable

In a good place

Well informed

Well organized

Confused

Not understood

Worried

Lonely

Unsure of staff

Disorganized

Other (please specify)

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3.Rate your overall satisfaction with Headwaters

Poor

Fair

Average

Good

Excellent

Poor

Fair

Average

Good

Excellent

If you said "poor" or "fair", please describe why

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4.How likely would you be to recommend Headwaters to your family and friends?

Definitely would not recommend

Likely would not recommend

Neutral

Likely would recommend

Definitely would recommend

Definitely would not recommend

Likely would not recommend

Neutral

Likely would recommend

Definitely would recommend

If you would not recommend, please tell us why

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5.Please rank the following in order of importance to you

I receive quality & compassionate medical care

I am comfortable & safe

My basic personal needs are supported

My family receives the support they need

Communication is clear & open

Services are easy & convenient to get

I have timely access to services

The facility is clean, well-maintained & organized

Staff work like a team

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6.What is Headwaters best known for? What are the hospital's greatest achievements?

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7.What is Headwaters greatest value to the community? What are the most valuable services that the hospital provides to the community?

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8.In what areas does Headwaters need the most improvement? What missed opportunities should the hospital be working on?